Frontiers in Neurology (Jan 2023)

Characteristics of stroke service implementation in Armenia

  • Greta Sahakyan,
  • Mira Orduyan,
  • Sevak Badalyan,
  • Ani Adamyan,
  • Mariam Hovhannisyan,
  • Hasmik Manucharyan,
  • Sagatel Egoyan,
  • Yuri Makaryan,
  • Hovhannes Manvelyan

DOI
https://doi.org/10.3389/fneur.2022.1021628
Journal volume & issue
Vol. 13

Abstract

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BackgroundAcute stroke care service in Armenia was established in 2019 after the implementation of the National Stroke Program (NSP). This study aimed to provide an up-to-date account of the current image and clinical characteristics of acute stroke service implementation at a tertiary hospital in Armenia by analyzing the quality of care and identifying the areas that need improvement.MethodsWe analyzed patient data from a single hospital in 1 year after the establishment of acute stroke care service (February 2021–January 2022). We selected patients who were within 0–24 h from symptom onset at admission and included patients who benefited from reperfusion therapies (intravenous thrombolysis (IVT) and/or endovascular thrombectomy (EVT)). A favorable outcome was defined as a drop in the National Institutes of Health Stroke Scale (NIHSS) by more than four points at discharge and a modified Rankin score (mRS) of 0–2 at 90 days.ResultsOf the total 385 patients, 155 underwent reperfusion therapies, 91% of patients (141/155) arrived by ambulance, 79.2% (122/155) had neurological improvement at discharge, and 60.6% (94/155) had an mRS of 0–2 at 3 months. Less than 5% of patients had early direct access to the rehabilitation center.ConclusionOur study demonstrated that the implementation of NSP with organized protocol-driven inpatient care led to significant advancement in acute stroke service performance. We believe that our report will serve as a model for achieving advanced and structured stroke care in a resource-limited context and contribute to the future development of the healthcare system in our country.

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